Saturday, October 30, 2010

The Invisible Two Percents

“Mrs Jones, you have a 98% chance of doing well with your surgery.” Most of us would leap at those odds when two percent is couched that way.

But like banking computers that round the penny in the bank’s favor, two percent can add up remarkably fast. Even worse, it's hard to track lots of 2 percents if they happen over and over again.

Now take a moment and think of all the places where the government has decided to withhold two percent from physicians lately:

“EPs (eligible professionals) who do not demonstrate that they are meaningful users of certified EHR technology will receive an adjustment to their fee schedule for their professional services of 99 percent for 2015 (or, in the case of an eligible professional who was subject to the application of the payment adjustment under section 1848(a)(5) of the Act, 98 percent for 2014), 98 percent for 2016, and 97 percent for 2017 and each subsequent year.”

“Beginning with the 2010 eRx Incentive Program, a group practice may also potentially qualify to earn an eRx incentive payment equal to 2% of the group practice's total estimated Medicare Part B Physician Fee Schedule (PFS) allowed charges for covered professional services furnished during the 2010 eRx reporting year based on the group practice meeting the criteria for successful electronic prescriber specified by CMS.”

“Eligible professionals who satisfactorily report quality-measures data for services furnished during a PQRI reporting period are eligible to earn an incentive payment equal to a percentage of the eligible professional's estimated total allowed charges for covered Medicare Part B Physician Fee Schedule (PFS) services provided during the reporting period.

Below are the authorized incentive payment amounts for each program year:• 2007 PQRI – 1.5% subject to a cap;• 2008 PQRI – 1.5%;• 2009 PQRI – 2.0%; and• 2010 PQRI – 2.0%.(Note that these “incentives” are actually withheld by CMS until they are “earned” back)

With each of these incentives comes ghastly and nearly uninterpretable governmental paperwork requirements to retrieve all those 2 percents. Take, for instance, this detailed example of the form that must be completed to recoup 2 percent (90 cents!) of a single $45 office charge based on PQRI measures.

Oh. My. Goodness.

And tracking that "incentive" payment to assure payment? Best of luck.

The governmental two percents. Going… going… gone.

Over and over again.

That, my friends, is what doctors must now accept if they're going to survive in our new era of health care "reform:"

.. the invisible, burdensome, and untraceable two percents... all soon to be "bundled" away.

In 2007, doctors in Cuba received $30-40 per month. And, Cuba had great health statistics for average lifespan and infant mortality ( or maybe NOT ).

So, our government has lots of room to "adjust" doctor's compensation while maintaining superb healthcare for everyone. The same quality of healthcare that the kulaks and businessmen (con men) receive now.

Anyway, doctors should work for next to nothing, just for the privilege of helping their community, just like our Senators and Congressmen do now.

The important thing is that all of the rules, regulations, and treatment patterns will be followed, with no deviation or error. Just like our Senators and Congressmen do now.

Wonderful camparison between Cuba and the US. Cuba physicians make $360 annually - US physicians make a pitiful 500 times more (some a little less, some a lot more). Next we'll be comparing Obama to Hitler. Wait! It's already being done!

About Me

Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005.
DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.